Trends in the use of postoperative radiation therapy in patients with localized resectable pancreatic cancer.

Shinohara ET, Mitra N, Fei W, Kirschner AN, Metz JM
Am J Clin Oncol. 2012 35 (6): 543-8

PMID: 21926898 · DOI:10.1097/COC.0b013e31822dfd3c

OBJECTIVES - : Results from European Study Group for Pancreatic Cancer (ESPAC)-1, first published in 2001, suggested that postoperative radiation therapy (PORT) was detrimental in pancreatic patients. The potential association between the publication of ESPAC-1 and the use of PORT in the United States is examined in this study.

METHODS - : Data from the Surveillance, Epidemiology, and End Results program were used to identify pancreatic patients treated with surgical resection followed by PORT. The use of PORT was examined in the 5-year time period preceding and after the publication of ESPAC-1.

RESULTS - : Univariable analysis of the use of PORT found significantly less use of PORT in the postpublication period [odds ratio (OR) for the use of PORT in prepublication period=1.19, 95% confidence interval (CI), 1.04-1.35]. A multivariable analysis, performed to account for imbalances in clinical and demographic variables between the 2 time periods, found similar results (OR=1.18, 95% CI, 1.03-1.35). When other types of radiation, such as preoperative radiation were included, no significant difference between time periods was found (OR=0.99, 95% CI, 0.76-1.30).

CONCLUSIONS - : Although there continues to be frequent use of PORT in the United States, the publication of ESPAC-1 seems to be associated with a small but significant change in its use. However, it is important to note that further analyses suggest that a small shift toward more preoperative radiation may also account for the decrease in PORT.

MeSH Terms (17)

Aged Aged, 80 and over Confidence Intervals Female Humans Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Pancreatic Neoplasms Postoperative Care Radiotherapy, Adjuvant Randomized Controlled Trials as Topic SEER Program Serial Publications United States

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